Nursing interventions with people with obesity in Primary Health Care: an integrative review.

Objective Identify the knowledge produced on nursing interventions with people suffering from obesity in Primary Health Care. Method Integrative literature review of publications indexed in the databases: CINAHL, LILACS, MEDLINE, SciELO, SCOPUS and WEB OF SCIENCE, between 2011 and 2016. Results Thirty-three articles were selected. The knowledge produced covered two themes: "Counseling aimed at weight control and promotion of healthy lifestyle habits" and "Perception of Primary Health Care nurses regarding interventions with people with obesity." Conclusion The results may help prompt reflections on professional training, management, and health services in terms of the relevance of nurses working with people suffering from obesity, with the support of digital technologies, motivational techniques, and nursing consultations. This could enhance their activities in the multiprofessional teams in which they participate at this healthcare level.

Maintenance of tobacco withdrawal by former smokers: a phenomenological study. / Manutenção da abstinência do tabaco por ex-fumantes: estudo fenomenológico.

OBJECTIVE To understand the experience of former smokers maintaining tobacco abstinence. METHODS Qualitative research using the theoretical-methodological reference of the Social Phenomenology, as defined by Alfred Schütz. The phenomenological interview was carried out in 2016 with 12 former smokers from a city in the state of Minas Gerais, Brazil. The statements were organized into categories and discussed based on the literature. RESULTS The maintenance of tobacco abstinence was revealed in the categories: "Health, sociability, and financial gains"; "Living with the urge to smoke and with the increase of body weight"; "Self-determination and use of replacement strategies"; and "Staying away from cigarettes." CONCLUSIONS These results alert health professionals to the need to provide support to former smokers so they can remain smoke-free. This implies considering not only the negative effects of the tobacco abstinence, but also the social context in which former smokers are inserted that might have an impact on the maintenance or not of the cigarette withdrawal.

Intimate partner violence among speaking immigrant adult Portuguese women in Canada.

OBJECTIVE: This study was conducted to understand the experiences of intimate partner violence among women from Portuguese-speaking countries living in the Greater Toronto Area. METHOD: A social phenomenological study was conducted with ten Portuguese-speaking women who had experienced intimate partner violence who were selected by community centre leaders. The interviews were transcribed, translated and analysed by categories. RESULTS: The consequences of violence included health problems, effects on children, and negative feelings among the victims. Factors preventing the women from leaving abusive partners included religious beliefs, challenging daily jobs, and the need to take care of their husband. Factors that encouraged them to leave included getting support and calling the police. Some women expressed hope for the future either with their husband. Others, desired divorce or revenge. Their plans to rebuild their lives without their husband included being happy, learning English, and being financially stable. CONCLUSION: Using these findings can implicate in the improvement of care for these women.

[Understanding unsuccessful attempts to quit smoking: a social phenomenology approach]. / Compreendendo o insucesso da tentativa de parar de fumar: abordagem da fenomenologia social.

OBJECTIVE: The aim of this paper is to understand the experience of smokers in view of unsuccessful attempts to quit smoking. METHOD: This study is based on social phenomenology. Between November and December of 2014, nine interviews were conducted with people that had attempted to quit smoking. The content of these interviews was analyzed and discussed based on the related literature. RESULTS: Unsuccessful attempts to quit smoking are related to tobacco addiction; cigarettes are seen as a support to cope with everyday stressful situations. Attempts to quit the smoking habits were based on the need of health improvement and insistence of family and friends. Smokers reported the use of habit cessation strategies learned in support groups, but they also express expectation of specialized psychological support. CONCLUSION: The study points out the need to expand the strategies of approaching smokers, and reinforcing psychological support in order to achieve success in the attempt to quit smoking.

Understanding of the life experience of homeless women.

OBJECTIVE: To understand the life experience of homeless women. METHOD: A social phenomenological study was conducted with 10 women assisted by a shelter. The analysis of the interviews was based on the theoretical framework of social phenomenology of Alfred Schütz and thematic literature. RESULTS: The participants face adversities in the street context, with emphasis on the risk of physical and sexual abuse, and seek shelters as a possibility for minimizing difficulties experienced. They hope to leave the streets; however, they see themselves trapped in this social reality, due to the addiction to alcohol and other drugs. CONCLUSION: The understanding of the life experience of homeless women shows daily confrontations and reveals the conflict between the desire for leaving and remaining on the streets, given the complexity of the reality that keeps them in this condition. OBJETIVO: Compreender a vivência de mulheres em situação de rua. MÉTODO: Pesquisa fenomenológica social realizada com 10 mulheres assistidas por um albergue. A análise das entrevistas ancorou-se no referencial teórico da fenomenologia social de Alfred Schütz e literatura temática. RESULTADOS: As participantes enfrentam adversidades no contexto da rua, com destaque para o risco de violência física e sexual, e buscam o albergue como possibilidade de minimizar as dificuldades vivenciadas. Elas têm como expectativa sair da rua, porém se veem presas a esta realidade social em virtude do vício em álcool e outras drogas. CONCLUSÃO: A compreensão da vivência de mulheres em situação de rua aponta enfrentamentos cotidianos e revela o conflito entre o desejo de sair e permanecer na rua, dada a complexidade da realidade que as mantém nesta condição.

Older Brazilian women's experience of psychological domestic violence: a social phenomenological study.

BACKGROUND: Domestic violence is a global public health issue, as it is in Brazil. The psychological violence is one of the most prevalent forms of domestic violence, affecting more women than men. However, many older adults do not consider it as a type of domestic violence. In addiction, psychological violence has received little attention from researchers. So, this study aims to further understand the phenomenon of psychological domestic violence perpetrated by relatives against older adult women (60 years and older). METHODS: A qualitative study was conducted using a social phenomenological approach proposed by Alfred Schütz. In-depth interviews were conducted with 11 older Brazilian women from three different agencies, two in Campina Grande and one in São Bernardo do Campo. Data collection took place between November 2012 and February 2013. We performed data analysis using the key concepts (such as the world of everyday life, natural attitude, intersubjetivity, stock of knowledge, biographical situation, social action, motivation and typification) proposed by Alfred Schutz. RESULTS: Despite the fact that participants reported being psychologically abused, they also referred to being neglected and financially abused. They revealed being threatened, disrespected, neglected, financially abused, forced to do housework, and humiliated. Older women expressed feelings of sadness, anger, grief, and fear, which had negative effects on their health. Attempts by the participants to change their current situations were unsuccessful and resulted in feelings of helplessness. The abuser's behaviour will change, and leaving the abusive situation were two possible outcomes pointed for participants. CONCLUSIONS: A support network is crucial to help changing the behaviour of aggressors and/or to help older adult women leave the abusive situation. Further research is needed to understand the risk factors linked to abuse behaviours, to develop educational programs for the abusers, and to design social support for the victims.

Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers.

Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions.

[The decision of an obese woman to have bariatric surgery: the social phenomenology]. / A decisão da mulher obesa pela cirurgia bariátrica à luz da fencomenologia social

OBJECTIVE: To understand the process by which an obese woman decides to have bariatric surgery. METHOD: A qualitative survey with a social phenomenology approach, carried out in 2012, with 12 women, using the phenomenological interview. RESULTS: A woman bases the decision to have the surgery on: the inappropriateness of her eating habits; a physical appearance that is incompatible with an appearance that is standardized by society; the social prejudice that she has to live with; the limitations imposed by obesity; and her lack of success with previous attempts to lose weight. Outcomes that she hopes for from the decision to have the surgery include: restoring her health; achieving social inclusion; and entering the labor market. CONCLUSION: This study allows one to reflect that prescriptive actions do not give a satisfactory response to a complexity of the subjective questions involved in the decision to have surgery for obesity. For this, what is called for is a program of work based on an interdisciplinary approach, and training that gives value to the bio-psycho-social aspects involved in a decision in favor of surgical treatment.

Role of nurses in a field hospital aimed at patients with Covid-19.

OBJECTIVE: To understand the role of nurses in field hospitals aimed at patients with Covid-19. METHODS: Qualitative research based on Alfred Schütz's social phenomenology. Twenty nurses working in São Paulo were interviewed between May and June 2020. The testimonies were organized and analyzed based on the theoretical-methodological and thematic framework. RESULTS: The following categories emerged: "Nurses' challenges in field hospital care", "Visibility of nursing in the Covid-19 pandemic scenario" and "Covid-19 post-pandemic professional valorization". FINAL CONSIDERATIONS: The reflection on the results that emerged in this study may contribute to support improvements in training, working conditions and valuing nurses, considering the importance of this professional category in the scope of health services. New investigations may increase knowledge in the area, providing subsidies for professional role in this and other health situations that require nursing intensity and excellence.

Older adults with physical disabilities: vulnerabilities relative to the body, the physical and social environment.

OBJECTIVE: to understand the vulnerabilities of older adults with physical disabilities regarding their body, physical and social environments. METHOD: this was a qualitative study based on Alfred Schütz' social phenomenology, with 15 older adults with physical disability from Cuiabá, state of Mato Grosso, Brazil. Open-ended questionnaires were administered to the participants in 2017. The units of meaning that emerged were organized into thematic categories. RESULTS: physical decline, associated with the permanence of environmental and social barriers intensified the vulnerabilities of older adults. Gaps in health services are mitigated by informal social support networks and access to work was a form of social inclusion. FINAL CONSIDERATIONS: vulnerabilities in the old age of persons with physical disabilities did not reside only in the body dimension, but also the physical and social environment, countering healthcare models based on the logic of reverting their dysfunctional body.

Path taken by morbidly obese people in search of bariatric surgery in the public health system.

OBJECTIVE: to understand the path taken in the public health system by people with morbid obesity in the search for bariatric surgery. METHOD: qualitative research based on the social phenomenology of Alfred Schütz, with 17 hospitalized morbidly obese people, with a scheduled date for bariatric surgery. The phenomenological interview with open questions was used and the statements were analyzed in the light of the theoretical-methodological framework and literature related to the theme. RESULTS: the participants were able to schedule bariatric surgery by referring friends, family and public people. The waiting list for the procedure generated anguish and anxiety due to fear of surgery, weight gain, risk of worsening health and physical limitations, but it helped prepare for its performance. The experience lived in the search for bariatric surgery led these people to want continuity of care in the Basic Health Unit, after the surgery, by professionals trained to meet their needs. CONCLUSION: the aspects inscribed in the path of people in search of bariatric surgery signal the need to strengthen the assistance-related flows of the public health system and to invest in professional training to reduce the social inequalities in access to bariatric surgery and increased quality of services.

Experiences and expectations of obese older people on the care received in the primary health care network.

OBJECTIVE: to understand the experiences and expectations of obese elderly people on the care they received in the primary health care network. METHODS: phenomenological study, in which 16 obese elderly people living in a municipality in the state of Minas Gerais, Brazil, were interviewed. Their statements were organized into categories and analyzed according to Alfred Schütz's social phenomenology and thematic literature. RESULTS: the following categories emerged: "Care neglected to obese elderly people in the primary health care network", "Group activities as a way to provide primary health care to obese elderly people: a present past", and "Qualified longitudinal care, centered in the needs of obese elderly people". FINAL CONSIDERATIONS: offering comprehensive and longitudinal primary health care to obese older people was difficult, and there was instability in the consolidation of public policies, which pointed out the need for effective bonds between different healthcare network services and between professionals and users.

Actions of nurses toward obesity in primary health care units.

OBJECTIVES: To understand the actions of nurses toward obesity in primary health care units. METHODS: A phenomenological study was carried out with 12 nurses of a city in the state of Minas Gerais. The interviews were organized into categories and analyzed according to the social phenomenology of Alfred Schütz and literature associated with the theme. RESULTS: The following categories emerged, expressing the actions of nurses toward obesity prevention and control: "Guidance on healthy lifestyle habits", "Barriers to the actions of nurses", and "Focusing specifically on obesity". FINAL CONSIDERATIONS: Considering that guidance on healthy lifestyle habits was mostly carried out during individual and collective activities directed to the general population, regardless of their weight conditions, nurses must reorganize their professional practice in primary health care units by implementing specific actions for users with obesity or at risk of developing it.

The health care experience of individuals with morbid obesity assisted in public healthcare services.

OBJECTIVE: To understand the health care experience of individuals with morbid obesity assisted in public healthcare services. METHOD: This was a qualitative study based on Alfred Schütz's social phenomenology, carried out in the medical-surgical clinic of a public hospital in São Paulo, Brazil. Interviews with open questions were conducted between January and April 2017. RESULTS: Seventeen individuals with morbid obesity participated in the study. The findings revealed care(lessness) experiences of obese individuals in the Brazilian Healthcare System in terms of structure/logistics and human resources. Study participants shared care expectations about health care management and staff, and further considered the Primary Health Care service as a scenario of power to have their obesity-related care needs met. CONCLUSION: The findings need to be carefully (re)examined by the healthcare system's micro- and macro management, as well as by health teaching and research personnel, in order to integrate, follow up and qualify care actions towards the prevention and control of obesity in public healthcare services.

Nursing approach to tobacco users in primary health care.

OBJECTIVE: to understand the experience of nurses in the approach to tobacco users in primary health care services. METHOD: Qualitative, phenomenological research with 15 nurses who were interviewed between January and March 2017. Their speeches were analyzed and classified into categories. RESULTS: the approach by nurses to tobacco users is performed in an individual and unsystematic manner and in operative groups in accordance with the principles of the cognitive-behavioral therapy. This is a complex approach due to issues related to users themselves and to human, material, and structural resources. The expectations of nurses include supporting smoking cessation and expanding the tobacco use prevention work in educational environments. FINAL CONSIDERATIONS: this study points out that nurses need to use the nursing care systematization in coordination with the recommendations of policies aimed at tobacco use control to perform their role in the promotion, control, and reduction of health complications in tobacco users.

Experience of adults and older people with adherence to venous ulcer care. / Experiência de pessoas adultas e idosas frente à adesão aos cuidados com a úlcera varicosa.

OBJECTIVE: To understand the experience of adults and older people with adherence to venous ulcer care. METHOD: A qualitative study based on the concepts of Alfred Schütz's social phenomenology was carried out with 12 adults and older people undergoing venous ulcer treatment in a specialized service in the state of Minas Gerais. The interviews were carried out from October to November 2015, analyzed, categorized, and discussed based on the theoretical-philosophical framework adopted and on thematic literature. RESULTS: The following thematic categories emerged from the interviews: "beliefs and personal and social activities hindering adherence to care"; "being protagonists in the care relationship with venous ulcers", and "motivation for adherence to care". CONCLUSIONS: The intersubjective relationship established between patients with venous ulcers and healthcare professionals emerged as a driving force for adherence to care. Promoting the reciprocity relationship of perspectives between these social actors may promote greater adherence to venous ulcer care.

Experience of adults with cystic fibrosis: a perspective based on social phenomenology.

OBJECTIVE: To understand the experience of adults living with cystic fibrosis. METHOD: A qualitative study based on the social phenomenology by Alfred Schütz, carried out with 12 adults interviewed in 2016. The statements were analyzed and organized into concrete categories. RESULTS: The following categories were evidenced: "The biopsychosocial impact of the disease on daily life", "Social prejudice as a generator of embarrassment", "Coping strategies" and "Fear, uncertainties and the desire to carry out life projects". FINAL CONSIDERATIONS: The understanding of the experience lived by adults with cystic fibrosis allowed unveiling intersubjective aspects experienced by this public that should be considered by health professionals in the care of this group. It is up to the professionals involved in assisting these people to develop care strategies aimed at completeness, respect for the world of meanings of each individual, their life history, and intersubjectivity that is specially built in the relationship between professionals and people with cystic fibrosis.

Primary health care: the experience of nurses.

OBJECTIVE: to understand the meaning of nursing care in primary health care from the perspective of Chilean nurses. METHOD: this was a qualitative study based on the social phenomenology of Alfred Schutz. Data was collected between January and April 2013, through interviews with 13 primary health care nurses in Chile. RESULTS: the nurses perceived primary care as a gratifying experience, considering it an encounter of subjectivities. However, they felt burdened with multiple functions and by the hierarchical pressure to achieve targets. They strived to implement innovative care, expressed by the desire to go beyond traditional care practices, and improve the efficiency of management at the various levels of health care. CONCLUSION: it is important to discuss the results of the present study in the context of health care and especially nursing education, with the goal of better preparing nurses who will deliver care at the primary health care level.

Needs, expectations and care production of people in street situation.

OBJECTIVE: To understand the needs, expectations, and care production of people in street situations. METHOD: This is a qualitative study based on social phenomenology, conducted with eight people in street situations. Data were collected through a phenomenological interview from September to December, 2016. RESULTS: The needs of participants refer to survival and access to health services. Care production involves physico-biological, spiritual, and affective-social aspects. The expectations of these people involve a desire for health care that considers their singularities and offers them social apparatuses. FINAL CONSIDERATIONS: This study has contributions to the practice, training on health, and nursing in collective health, regarding care planning and provision to the population in street situations based on their expectations and lifestyles, considered as tools to help fulfill the health needs of this social group.

Unna's boot: experience of care of people with venous ulcers.

OBJECTIVE: to understand the experience of care of people with venous ulcers using an Unna's boot. METHOD: a qualitative study, based on the social phenomenology by Alfred Schütz, was carried out with 12 adults interviewed in 2015. The statements were analyzed and organized in thematic categories. RESULTS: the following categories emerged: "Unna's boot annoyance versus wound improvement", "Difficulties for accessing care with the Unna's boot", "Care for healing and preventing recurrence", and "Receiving more attention from the healthcare professional". CONCLUSION: the experience of care of people using an Unna's boot revealed the annoyance caused by this device, which was overcome due to the wound improvement. However, access to care was compromised by the lack of structure at the service, frustrating the patients' expectations regarding wound healing. The issues of these people's intersubjective universe should be considered in the management of care of venous ulcers.